Summary The proposed analysis FIT-PLESE: Tracking Lipids utilizes serum and blood from obese infertile women enrolled in the Reproductive Medicine Network trial FIT-PLESE who conceived and carried their pregnancy and delivered. The objective is to determine what changes occur in atherogenic apolipoproteins (small LDL particles, ApoB, LP [a], and omega acids) with immediate pre-pregnancy diet and/or exercise with or without weight loss and if changes are maintained during pregnancy. FIT-PLESE provided monitored exercise and/or prepared meals with an over the counter weight loss medication to infertile obese women immediately prior to ovulation induction with intrauterine insemination. For those who conceived, labs were drawn pre and post intervention and at 16, 24 and 32 weeks of pregnancy. Mechanistically how do apolipoproteins lipids specifically change with the intervention(s) and which changes are essential with and without weight loss to fewer pregnancy complications? Specific pregnancy complications preterm birth, SGA, LGA, diabetes, preeclampsia) with specific apolipoprotein, responses will be associated. The long-term goal is to determine which specific atherogenic apolipoprotein response is key. This secondary analysis of existing data is to obtain key information as Pilot data. A larger subsequent R01 submission will follow. Pharmacological and/or non-pharmacological therapies will now have specific targets for reduction leading to better maternal/child outcomes. With respect to outcomes, we expect that understanding best responses to the interventions will have short-term, long-term, and generational benefits.